Autonomic nervous system
Clinical neurophysiology
Critical care
P 2121
Myocardial 123I-metaiodobenzylguanidine (MIBG)
Scintigraphy for the assessment of cardiac sympathetic
nervous dysfunction in diabetic patients
J . Nunomura
1
, O. Uehara
2
, M. Baba
3
, M. Matsunaga
3
1
Department of Neurology, Municipal Kuroishi Hospital,
Kuroishi, Aomori, JAPAN,
2
Department of Internal Medicine,
Municipal Kuroishi Hospital, Kuroishi, Aomori, JAPAN,
3
Department of Neurology, Hirosaki University, Hirosaki,
Aomori, JAPAN
Purpose Although diabetic autonomic neuropathy constitutes
serious complications, there are few methods for early detection
of abnormalities. In this study, we conducted 123I-MIBG myo-
cardial scintigraphy, which is currently applied as a test of
cardiac sympathetic nerve function, on diabetic patients, and
assessed its usefulness by comparing with the results of sympa-
thetic skin response (SSR), which is a method for evaluating
peripheral sympathetic nerve activity.
Subjects We examined 29 cases of type 2 diabetes that did not
present autonomic dysfunctions (11 males and 8 females). The
average age of the subjects was 64.9 years and the mean dura-
tion of diabetes was 13 years.
Methods MIBG uptake was quantified by calculation of the
heart - mediastinum ratio (H/M ratio) that was calculated by
average count per pixel in the regions of interest over heart and
mediastinum on the planar anterior image of the chest. In addi-
tion, the washout rate (WR) was also calculated. SSR was per-
formed followed by determination of amplitude and latency.
Results According to the results of 123I-MIBG myocardial
scintigraphy, abnormalities in H/M ratio and WR were observed
in 10 cases. Decreased amplitude was observed in 9 cases in
SSR. H/M ratio and WR did not correlate with symptoms of
diabetic peripheral neuropathy, and there was no correlation
observed with the results of SSR as well.
Discussion 123I-MIBG myocardial scintigraphy, along with
SSR, is a simple and objective evaluation method, and is con-
sidered to be a useful method for assessing early diabetic auto-
nomic neuropathy.
P 2122
Sympathetic skin response and foot ulceration in diabetes
P. Kokotis
1
, A. Karanti
3
, N. Tentolouris
2
, P. Tsapogas
2
,
N. Katsilambros
2
, U. Smith
3
and C. Karidakis
1
1
Neurological Department of Laiko Hospital, Athens,
GREECE,
2
1
st
Department of Propaedeutic Medicine, Athens,
University Medical School, Athens, GREECE,
3
Department
of Internal Medicine, Sahlgrenska University Hospital,
Gothenburg, SWEDEN
Background-Aims This study examined the relationship bet-
ween sympathetic skin response (SSR) as a reliable test of auto-
nomic nervous system function and foot ulceration (FU) in
diabetes.
Materials and Methods 64 patients with either type 1 or type
2 diabetes were studied. Diagnosis of peripheral sensory neuro-
pathy (PN) was based on clinical symptoms, signs and vibra-
tion perception threshold. DS were divided in 3 groups: without
6th EFNS Congress, Vienna, 2002 138
© 2002 EFNS European Journal of Neurology 9 (Suppl. 2), 105–161